Three ethical issues around pig heart transplants

A US man has become the world's first person to get a heart transplant from a genetically modified pig.

• The case is of 57-year-old David Bennett, who doctors say was too ill to qualify for a human heart.
• After the surgery, he is doing well now. 
• The surgery is being hailed by many as a medical breakthrough that could shorten transplant waiting times and change the lives of patients around the world. 
• But some are questioning if the procedure can be ethically justified.
• They have pointed to potential moral trouble spots over patient safety, animal rights and religious concerns.

How was it done?

• The heart used in the transplant came from a pig with several genetic modifications, including some to knock out genes that trigger the human immune system.
• Since the human immune system rejects anything that is foreign, whether from another person who is immunologically matched to the recipient or from a different species such as a pig, scientists had to tweak the pig genome to make the organ less likely to be rejected.
• Scientists altered 10 genes in the pig whose heart was used for Mr Bennett's transplant so it would not be rejected by his body.
• The pig had its heart removed on the morning of the operation.
  
  
  

What are the ethical issues involved in experimental surgery?

The medical implications

• This is an experimental surgery, and brings with it huge risks for the patient. 
• Even well-matched human donor organs can be rejected after they are transplanted - and with animal organs the danger is likely to be higher.
• Doctors have been trying to use animal organs for what is known as xenotransplantation for decades, with mixed success.
• In 1984, doctors in California tried to save a baby girl's life by giving her the heart of a baboon, but she died 21 days later.
• While such treatments are very, very risky, some medical ethicists say they should still go ahead if the patient knows the risks.

Animal rights

• Mr Bennett's treatment has also re-sparked a debate over the use of pigs for human transplants, which many animal rights groups oppose.
  • One of them, People for the Ethical Treatment of Animals (PETA) has condemned Mr Bennett's pig heart transplant as "unethical, dangerous, and a tremendous waste of resources".
• "Animals aren't tool-sheds to be raided but complex, intelligent beings," PETA said.
• It is wrong to modify the genes of animals to make them more like humans.
• Animals have a right to live their lives, without being genetically manipulated with all the pain and trauma this entails, only to be killed and their organs harvested.
• Some campaigners have concerns regarding the unknown long-term effects of genetic modification on the pig's health.

Religion

• Another quandary could emerge around those whose faiths might mean it is tricky for them to receive an animal organ.
• Pigs are chosen as the relevant organs are a similar size to humans' - and because pigs are relatively easy to breed and raise in captivity.
• But how does this choice affect Jewish or Muslim patients, whose religions have strict rules on the animal?
• Although Jewish law forbids Jews from raising or eating pigs, receiving a pig heart is "not in any way a violation of the Jewish dietary laws.”